Method: In a pilot study, 300 older adults (~75% with T2D and 25% with prediabetes) from South Florida were randomly assigned to Peer Only, Peer & TeleH, or Standard care interventions and followed-up for 6 months. Interventions were based on modules used in the Diabetes Prevention Program. A peer-leader manual and mobile platform for the telehealth intervention were prepared based on input from focus groups among potential participants. The intervention included counseling on diet, exercise, and other health management issues. We measured 8 subscales of health related quality of life using the SF-36 at base line and 6 month follow up.
Result: Participants had a mean age of 67.1 ± 5.4 years; 94.7% were male, 38.7% were Black, and 21.7% were Hispanic. The physical function subscale mean was 58.7 (±1.7) at baseline and 58.6 (±1.8) at 6 months follow up; emotional well-being subscale mean was 68.8 (±1.4) at baseline and 68.5 (±1.4) at follow up. In t-tests between baseline and 6 months follow up, there were no significant differences over time or among the intervention arms in these two measures. Of the other 6 SF-36 subscales, only social functioning showed a significant change over time: a significant decline from 68.8 (±1.7) to 65.9 (±1.7), which was significant overall and for both active intervention arms. Multivariate linear regression with change in subscale measures as the dependent variable, showed that the emotional well-being subscale was significantly, negatively, associated with being in the intervention arms after controlling for demographics variables.
Conclusion: Lifestyle interventions delivered through peer-leaders and/or telehealth are being shown to be effective in improving physiological outcomes. However, although our results for effects on health related quality of life are largely non-significant, the few significant results showed negative consequences of the active arms on social and emotional subscales. More research is needed to determine the mechanisms for these counterintuitive outcomes.